lfredrick123

We had exactly the same thing happen. Actually sent for records twice too. The last batch we not only got the blank sheets but a hen scratch note that hubby had lacerated his hand and had sutures put in and a tetanus shot (I think) and that was it, no return to clinic notes on removal of stitches or follow up, nor initial injections at entry, and while there is a note about being in ward, not a word on why or when. A follow up urine that says "retake" and a note that GFR was 1.4 and that chest was ok. No vitals nothing else. At discharge there is a form that basically says he was waiving his right to file a comp claim but could do so again later if he chose. Whats that all about?

We are sitting with DRO Review Pending since June 2015. Thats 734days. Got ya beat!

Hooray for you BroncoVet! I love hearing good news for these brave souls. Keeping my fingers crossed we will win too.

Hi Berta. Thank you for your help. We originally filed the claim for CVA/Stroke due to HTN which is what Dr Ellis wrote. The Dural AV Fistula we believe was formed due to the head injury he had that wasnt treated but the cut to his hand that nearly severd his fingers was service connected for 10%. In 1962 unless you were knocked totally out unconscious they paid little attention to a head wack. So he never got it treated just the fingers sutured back together. He got that without any difficulty because I had a small notation of it in his record but nothing on the head bump. I am told that while AVMs are considered congenital they can form from a head trauma. We never knew he had it until the stroke. I am the veterans wife and 24hr caregiver. He had complained for as long as I knew him of headaches and pain in his neck and shoulder. He also had tinnitus that for him was a buzzing. The C and P examiner asked him about ringing. He tried to tell her he had buzzing and no ringing, and he had many years of problems trying to pop his ears. She just ignored what he said basically. The swooshing could have been pulsitile they never addressed it, could also explain why he had long stand fluid in the mastoid air cells. We are still waiting on DRO/Appeal now over 2 years for that. The HTN we believe started in Service when they were doing heavy spraying of Herbicides and Insecticides, Heavy breathing of Diesel exhaust and fumes, and solvents he used on his work assignment. It is very clear the HTN was not well controlled until after the stroke, and as I said I have statements from others that show he had the exposures and the environment he was in. likewise I tracked down the now retired Colonel who was in charge of public works and he sent me a statement that they had been using DDT.Chlordane, Lindane, 2.4.5T + 2,4,D (Brush Killer) , Malathion, Diazinon, Silvex, and Nicotine Sulfate. Benzene in the Diesel and solvents, and of course Triclorethane and PCB. The tanks contained asbestos and silica that came from the churning of soils by the tracks, on the Tanks, and was found as fireproofing on their components and fire blankets. The buildings were laced with it and in Germany were falling apart due to the age they were, not to mention the heat stoves they had. Just an enormous mess of exposures to things, I also found that in Germany they were using HIDAL sub kits for spraying of vectors, so it was airborn. That along with Industial Hygiene surveys that showed big concerns from 1956-64. We have stroke of course, CAD. A Fib, Chronic Obstuctive Lung Disease, (Asbestos),HTN, ED. Loss of use for both legs and arms, headaches, and hearing loss/ tinnitus. I did post the IMO here to Bronco Vet and its a link to open it. I will open it again here for you at the end of this. The fistuala was discovered when he had the stroke that blocked the petrosal sinus and the cerebellar hematoma not just hemorrhage during a cerebral arteriogram. They then did the emboliztion to stop the bleed, and the neurosurgeon went in to remove as he called it the biggest blood clot he has ever seen in 43 years of neurosurgery. This clearly is what caused the veins to block and rupture. The exposures are what broke the veins down to begin with. The VA does have a written statement from the Chief from another case in a 2001 BVA decision I found. It was from that that I tracked him backwars myself because VA and DOD kept denying it. I found it all on my own without their help. I sought the surveys, and I researched every single thing I could find. I had a toxicologist explain the link and health effects and I found many peer studies on the issues, and have given VA the info. Still waiting. He was there at the very time the surveys were done. and he was in Germany when the HIDAL sprayers were in use. Dr Ellis sent along several peer studies, we had the Toxicologist review, and opine on the chemicals in use. As well as numerous articles on Carbon Monoxide,Diesel, Triclorethane and of course the Pesticides . I have affidavits from other lay persons who knew all this, and soldiers who also experienced it. So I think they have plenty on it and its connection to it. Here is Dr Ellis' opinion that I redacted. November 20, 2015 -------------------------------- Re: -------------------------- VA Fe: ------------------------ DOB: ----------- Sex: Male Expert Medical Opinion Concerning Service Connected Disability Department of Veterans Affairs: This veteran served honorably in the United States Army from 5/8/1962 to 5/11/1964 and then four years in the Ready Reserves. In May of 2008, Mr. ----------- had a stroke and has a tracheostomy and is not able to talk. He is in a wheel chair and is not able to come to be examined. His wife, ------- has power of attorney. My following opinions are based upon my phone conversation with --------------and review of medical records 18.1 cm thick. He was in good health when he went into the United States Army. He served in the Tank Corps as a turret artillery repairman. SERVICE CONNECTED INJURIES, DISEASES and CONDITIONS HYPERTENSION AND STROKE: His military service records indicate that on 3/13/62, at the age of 22, his blood pressure was 140190 and after exercise, 144/84. The medical records indicate that he continued to have high blood pressure after the military. He was treated for his hypertension. In May of 2008, he suffered a large cerebral hemorrhage secondary to a left superior petrosal sinus dural arteriovenous fistula. The stroke was devastating. He is in a wheelchair with tracheostomy. He is home bound and needs constant care. Service Connected Diagnoses: 7007 Hypertension. 8009 Hemorrhage of Brain Vessels. Service Connected Disability: 10% 7007 Hypertension. 100% 8009 Hemorrhage of Brain Vessels. 11302015 - VA Claims Intake Center, Janesville WI BEST COPY Nov 30 15 08:30a VFW Dept of __SVC Office ____________________ __________, M.D. November 20, 2015 Re: _______________) Opinion Concerning Service Connected Disability Causal Relationship and Connectedness to Military Service: It is my medical opinion, that it is more likely than not, that the blood pressure of 140/90 is objective proof that this service man at the young age of 22 had high blood pressure while in military service. It is my medical opinion, that it is more likely than not, that the continued hypertension caused increased pressure in the Blood vessels of the brain which caused abnormal anatomical changes in the blood vessels in the brain. It is my medical opinion, that it is more likely than not that the said abnormal changes in the blood vessels in the brain and the hypertension caused the vessels to bleed pouring blood into this veteran’s brain tissue causing the May 2008, cerebrovascular accident (stroke) and permanent brain damage. It is my medical opinion that it is more likely than not that service connected stroke has made this veteran home bound and in need of special adaptation for home bound care. RESTRICTIVE LUNG DISEASE/CHRONJC OBSTRUCTIVE PULMONARY DISEASE: While in the service he was frequently around volatile hydrocarbons such as diesel fumes,oils and solvents. He developed shortness of breath while in the service. The medical records show that he had continued worsening of his shortness of breath after the service. Service Connected Diagnosis: 6604 Chronic Obstructive Pulmonary Disease with Restrictive Component. Service Connected Disability: 30% 6604 Chronic Obstructive Pulmonary Disease with Restrictive Component. Causal Relationship and Connectedness to Military Service It is my medical opinion, that it is more likely than not, that this veterans exposures volatile hydrocarbons while in the tank corps caused injury to his lung tissues and causing chronic obstructive pulmonary disease and restrictive lung disease. This veteran never smoked. He has not been around any other type of smoke, fumes or chemicals that could cause the injury to his lungs. It takes very little exposure to volatile hydrocarbons to cause lung damage. For example, if a child ingests hydrocarbons such as gasoline or oil, the treatment is to not induce vomiting but let the material go on through the alimentary system. Even the very small amount of fumes from vomiting can cause further damage to the lungs. NOISE INDUCED HEARING LOSS and TINNITUS: This veteran was in the Tank Corps. He was around the as around other equipment. He was also around artillery in the service. Service Connected Diagnoses: 6100 Noise Induced Hearing Loss. 6260 Noise Induced Tinnitus. Service Connected Disability 0% 6100 Noise Induced Hearing Loss. 10% 6260 Noise Induced Tinnitus 11302015 - VA Claims Intake Center, Janesville WI BEST COPY Nov 30 15 08:29a VFW Dept of -- SVC Office --------- p.3 ----------, M.D. November 20, 2015 Re----------------- Medical Opinion Concerning Service Connected Disability Causal Relationship and Connectedness to Military Service: It is my medical opinion, that it is more likely than not that this veteran was frequently around noises louder than 95 decibels while in tanks and around artillery. Whenever the noise level is so loud that a normal conversation cannot be carried on, it is over 90 to 95 decibels. if one has to shout, it is definitely over 95 decibels. It is my medical opinion, that it is more likely than not, that his noise exposures in the service caused injury to the hearing cells in his ears and caused noise induced tinnitus and noise induced hearing loss. That his noise induced hearing loss is currently rated at 0%, does not mean that he does not have noise induced hearing loss. it only means that his injured hearing cells have not yet caused enough hearing loss to be rated. RECORDS REVIEWED: Attached is the ------------------ list of records reviewed. The records are 18.1 cm Thick. MEDICAL OPINION and CAUSE of INJURY: My medical opinions are based upon my examination of the veteran, review of medical and/or service records, my education training and experience and upon reasonable medical probability and reasonable medical certainty. It is my medical opinion that the injuries, impairments and disabilities set forth in my diagnosis and computation of service connected disability were, more likely than not, due to and consequence of this veteran’s military service. Respectfully, _____________ MD. Curriculum Vitae Summary (For full ci go to www.EllisClinic.com) Fellowships: American College of Occupational I and Environmental Medicine American College of Family Physicians Board Certifications: American Board of Family Medicine American Board of Environmental medicine Professional Certifications; Certified Forensic Consultant, CFCa Board Certified, American Board of Forensic Examiners Board Certified, American Board of Forensic Medicine Board Certified. American Board of Independent Medical Examiners Fellow, American Board of Disability AnaIysists JEJrI:va File Yrtl2O5.freg2O.1 12O1wpcJ Enclosures: 1. List of Records Reviewed 2. Curricuum Vitae of --------------MD

Similar situation for my husband. We got a piece of paper from the Baumholder clinic, but only stated seen for sutures due to cut, no details published and no x ray reports on the head wack that happened when he recoiled from nearly severing his right index finger on the tank cables and hit the hatch, Still believe that blow caused the formation of a dural arteriovenous fistula, that years later ruptured due to hypertension he developed in service thanks to the herbicides, insecticides, and diesel he was breathing all the time un protected. We got blank health record forms they had in his file but didnt complete. We had a hard time finding any records for him that far back but did get one from an employment exam he has right after service and then many record from private docs since 1998. His stroke was in 2008. Still waiting too. But you night be able to find records from that far back if you had insurance policies you applied for or an employers pre employment physical. Worth a try.

Sounds like they are just moving furniture in a burning house. Changing symantics does nothing to solve problems.

Bronco Vet - I finally did a redaction of the Nexsus here for you. Please let me know what you think. The CAD statement is not yet back.If you want to review it as I wanted the DBQ corrected first and the review done on all of the CT/MRI reports etc. There are a number of other issues still awaiting that as well. I dont want to stall the DRO/Appeal filing a new claim. God knows this is taking long enough. I do have CAD already filed and several others including incontinence. kidney, etc. See what your thinking or if I need more here. Gerald Fredrick- Dr Ellis Nexus.docx

Thank you kindly Broncovet. I would send you the info on the Nexus but dont want to overwhelm you with it all, and countles CT/MRI./ PFT's so on. I am 24/7 caregiver for him as he can not do any ADLs without help. We have been waiting now for years, Your help is so deeply appreciated.

Bronco vet I have the nexus too. Just cant get it to redact so cant post without the identifiable info on it. I am sending this for hubby who can not speak and is wheelchair bound. All well documented. Also have tons of proof of conditions on base including the Industrial Hygiene Surveys, the Colonels statement that they were using 2,4,5,T and the others, and affidavits showing that others also experienced them. I have the C file that they sent. and am waiting on the updated one. I also have a disk of all my VA med recs. And I found a form they had him sign at discharge stating he was aware he could file for compensation, but was declining to at that time (he just wanted out) and he could do so at a later date. I think I have it loud and clear, and am just waiting now on the DRO Review Hearing.

I believe the DBQ's show the diagnosis. As well as the private records. There were error in the PA statements that I have already asked VA to ammend. First he is on continuous oxygen, and he has proxyimal a fib, and he has private ekg that showed a AV Block on its readings twice, that they dont want to address. And because of the recurring infections, the damage to his lungs f rom exposures well documented and statements from many others about them. I believe we have all three. I have a nexus as well from IME , that states the stroke was caused due to hypertension that was shown in his service medical records. He also has arteriosclerosis, and he had a rupture due to weakened vessels due to hypertension. He also had a huge clot removed from the cerebellum as well as hemorrhaging. I am just wondering what else can be given or angle of attack here.

Bronco Vet thank you. Here are the DBQ's done recently showing the diagnosis, also the IME, and I have affidavits signed by other vets attesting to seeing and breathing the heavy spraying, and a letter from the Col who was in charge of the Public Works Department that says they were using 2,4,5,T,Chlordane, Lindane,Malathion, Diasinon, DDT,DDE, and Nicotine Sulfate, throughout the base, and a fellow soldier in the same unit in Germany on the HIDAL Subkit spraying at the border DBQ's for VA review.docx we were stationed. The Industrial Hygiene Survey that was done at the exact time I was there, that showed extensive levels of carbon monoxide and diesel fumes (benezene and other particulates), as well as noise levels all without protection and inexcess of limits, This coupled with the above

Here is the most recent CT Exam GOOD SAMARITAN MEDICAL CENTER Adm: 6/6/2017, D/C: 6/6/2017 CT Chest Abdomen And Pelvis Wo Contrast] Resulted: 06/06/17 1617, Result status: Final result Ordering provider: Resulted by: MD Performed: 06/06/17 1522 - 06/06/17 1539 Resulting lab: SVB STRESS SERVICES Narrative: CT OF THE CHEST, ABDOMEN AND PELVIS WITHOUT INTRAVENOUS CONTRAST EXAM DATE AND TIME: 6/6/2017 3:22 PM INDICATION: Lung mass. Vascular disorder of the kidneys. TECHNIQUE: Routine CT of the chest, abdomen and pelvis without IV contrast. Dose reduction techniques were employed. COMPARISON: None available. FINDINGS: CHEST: Lungs: Evaluation lung bases is hindered by extensive respiratory motion artifact. There is patchy left greater than right bilateral lower lobe consolidations, consistent with pneumonia and/or atelectasis. The upper lobes appear clear. Mediastinum/Hila: There is mild cardiomegaly. Aortic valvular calcifications are noted. Calcified plaque is seen in the aortic arch. No mediastinal or hilar adenopathy. Tracheostomy tube appears in satisfactory position. Pleura: Tiny left pleural effusion. Chest Wall: Right-sided VP shunt catheter is seen in the subcutaneous right anterior chest wall, terminating in the right upper quadrant of the abdomen. ABDOMEN: Liver: Normal size and homogeneous, without focal suspicious parenchymal lesion. Gallbladder/Bile Ducts: Few tiny calcified gallstones are seen layering in the gallbladder, which otherwise appears unremarkable. There is no biliary dilation. Pancreas: The pancreas appears normal. Spleen: The spleen appears normal. Adrenals: The adrenal glands appear normal. Kidneys: 3.3 cm simple left upper pole renal cyst. No hydronephrosis or nephrolithiasis. Bowel: Numerous colonic diverticuli are noted, without CT evidence of acute diverticulitis. Mesentery/Omentum/Peritoneum: The mesentery, omentum and peritoneum appear normal. Lymph Nodes: Lymph nodes appear normal. No adenopathy. Vessels: Calcified plaque in the abdominal aorta, without evidence of aneurysm. Abdominal Wall: The abdominal wall appears normal. PELVIS: Unremarkable urinary bladder. Unremarkable prostate gland. No free air. No free fluid. Printed on 6/8/2017 9:37 AM Page 1 GOOD SAMARITAN MEDICAL CENTER 200 Exempla Cir Lafayette CO 80026 FREDRICK,GERALD W MRN: S0406306 DOB: 2/28/1940, Sex: M Adm: 6/6/2017, D/C: 6/6/2017 CT Chest Abdomen And Pelvis Wo Contrast [213904399] (continued) Resulted: 06/06/17 1617, Result status: Final result BONES: Multilevel degenerative changes in the lumbar spine are noted. No destructive bony lytic or sclerotic osseous lesion. IMPRESSION: 1. Patchy bilateral lower lobe left greater than right consolidations, possibly representing atelectasis and/or pneumonia. Evaluation of these regions are hindered by extensive respiratory motion artifacts. Underlying mass, while considered less likely cannot entirely be excluded. Follow-up chest CT suggested after resolution of acute symptoms. 2. Right-sided VP shunt apparently in satisfactory position, tip terminating right upper quadrant. 3. Cholelithiasis, without CT evidence of acute cholecystitis. 4. Diverticulosis, without CT evidence of acute diverticulitis. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED: MD 6/6/2017 4:17 PM Contributed By: Printed What do you see in this report? as compared to the initial finding in February? 02/19/2017 6:16 PM Ordered By: , MD Result Status: Final result CT ABDOMEN AND PELVIS WO CONTRAST - Details About This Test The My Chart portal may not provide a complete representation of the laboratory test results in your medical record. If you have questions, please contact your physician. If the report is not complete, you may contact Health Information Management for a complete report. · Details Narrative HISTORY: 76M. Diarrhea. Noncontrast CT abdomen and pelvis with coronal and sagittal reformats. FINDINGS: Mild basilar atelectasis. Mild cardiomegaly. Right abdominal ventriculoperitoneal shunt partially seen extending along the liver. Dependent cholelithiasis without pericholecystic inflammation. Unremarkable spleen, adrenals, pancreas. Retroperitoneal lipomatosis with mildly atretic kidneys. Left renal 3.3 cm hypodense lesion with indeterminate density. Diffuse fluid-filled stomach, small bowel, and large bowel without evidence of obstruction compatible with infectious gastroenteritis/enterocolitis and diarrhea. Normal appendix, axial image 64. Distal colonic diverticulosis without diverticulitis. Central mesenteric misty appearance with subcentimeter lymph nodes. Unremarkable bladder. No free fluid or free air. Small fat-containing inguinal hernia is without inflammation. Bowel seen immediately deep to the umbilicus. No acute osseous finding. IMPRESSION: 1. Diffuse fluid-filled stomach and bowel compatible with infectious gastroenteritis or enterocolitis. 2. Indeterminate left renal 3.3 cm lesion, most, a hyperdense cyst. Recommend all sound further evaluate if not stable on prior exams. 3. Cholelithiasis. 4. Central mesenteric misty appearance with subcentimeter lymph nodes most commonly associated with mesenteric panniculitis or sclerosing mesenteritis. Consider 6 month follow-up CT abdomen. Component Results There is no component information for this result. General Information Collected: 02/19/2017 7:02 PM Resulted: 02/19/2017 7:02 PM Ordered By: MD Result Status: Final result Help Please!!!! Blood Testing KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM KAPPA LIGHT CHAIN, FREE, SERUM Reference Range: 3.3-19.4 (mg/L) Actual 41.3 H LAMBDA LIGHT CHAIN, FREE, SERUM Reference Range: 5.7-26.3 (mg/L) Actual 24.2 KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM Reference Range: 0.26-1.65 Actual 1.71 H DOB: 02/28/1940 Sex: M Phone: Patient ID: Age: 77 Fasting: Specimen: KS400824A Requisition: 7737005 Report Status: FINAL / SEE REPORT Collected: 05/31/2017 17:19 Received: 06/02/2017 06:23 Reported: 06/09/2017 05:21 Client #: 70300946 Quest, Quest Diagnostics, the associated logo, Nichols Institute, Interactive Insights and all associated Quest Diagnostics marks are the registered trademarks of Quest Diagnostics. All third party marks - '®' and '™' - are the property of their respective owners. Privacy policy can be found at: http://questdiagnostics.com/home/privacy-policy/online-privacy.html. © 2017 Quest Diagnostics Incorporated. All rights reserved. These results have been sent to the person that ordered the tests. Your receipt of these results should not be viewed as medical advice and is not meant to replace discussion with your doctor or other healthcare professional. Performing Sites AMD Quest Diagnostics/Nichols Chantilly-Chantilly VA, 14225 Newbrook Drive, Chantilly, VA 20151-2228 Laboratory Director: Patrick W Mason M.D.,PhD EZ Quest Diagnostics/Nichols SJC-San Juan Capistrano,, 33608 Ortega Hwy, San Juan Capistrano, CA 92675-2042 Laboratory Director: Jon Nakamoto MD,PhD THYROGLOBULIN THYROGLOBULIN Reference Range: <0.1 (ng/mL) Reference range applies to differentiated thyroid cancer patients following treatment. The presence of measurable thyroglobulin indicates the presence of thyroglobulin-producing thyroid tissue. Clinical correlation is advised. This test was performed using the Beckman Coulter Chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. Thyroglobulin levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. THYROID CANCER (THYROGLOBULIN) MONITOR THYROGLOBULIN ANTIBODY Reference Range: <=1 (IU/mL) This Thyroglobulin antibody test was performed using the Beckman Coulter Immunoenzymatic method. Values obtained from different assay methods cannot be used interchangeably. Thyroglobulin antibody levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. If the sample contains anti-thyroglobulin antibodies of greater than 1 IU/mL, the presence of these autoantibodies may cause falsely low thyroglobulin values. SEROTONIN, SERUM SEROTONIN, SERUM Reference Range: 56-244 (ng/mL) This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. 10.4 H Performing Location Name/Address: DENVER VA MEDICAL CENTER Lab Test: Immunogloblin Panel NOS Lab Type: Chemistry/Hematology Ordering Provider: Specimen: Serum (substance) Ordering Location: DENVER VA MEDICAL CENTER Date/Time Collected: 29 Mar 2017 @ 1525 Collected Location: Test Name Result Units Reference Range Status Performing Location IGA 464 High mg/dL (79-356) Final DENVER VA And last but not least Pulmonary 15 Mar 2017 @ 1328 Note Title: CHEST CLINIC CONSULT REPORT (T) Location: VA Eastrn Colrado HlthCare Sy Signed By: Date/Time Signed: 15 Mar 2017 @ 1717 Note LOCAL TITLE: CHEST CLINIC CONSULT REPORT (T) STANDARD TITLE: PULMONARY OUTPATIENT CONSULT DATE OF NOTE: MAR 15, 2017@13:28 ENTRY DATE: MAR 15, 2017@13:28:53 AUTHOR: URGENCY: STATUS: COMPLETED REASON FOR CONSULT: Suppressive therapy Mr. is a 77 yo man with a history as below presents for initial care. Doing ok right now. Has been having wheezing intermittently which improves with budesonide and duonebs. Uses vent at night (BiPAP 25/5 with 8LPM bleed in) and is on oxygen during the day 2-2.5 LPM TTO. Continues to have a chronic productive cough of thick, yellow sputum through his trach. No recent blood. No recent fevers > 100.4, chills or night sweats. No nausea, vomiting or abdominal pain. Had a bout of diarrhea that resolved early Feb 2017. Per Linda, his wife, started developing breathing trouble and was diagnosed with COPD in 2000. Since then, he had been experiencing shortness of breath with exertion and treated albuterol PRN. Subsequently, had a cerebellar dural AVM rupture complicated by chronic hypoventilation necessitating a tracheostomy. He has since then developed multiple infections with most recent sputum cultures 5/2015 growing klebsiella, psuedomonas, and stenotrophomonas. He has since been hospitalized multiple times for pneumonia, (twice in the last year). Since 2008, has had approximately 27-28 hospitalizations. FREDRICK, GERALD WALTER CONFIDENTIAL Page 9 of 18 Up about 8 lbs since 12/2016. Oxygen levels have been stable. Per St. Joes discharge (2/2017): "Mr. Fredrick is a 76yr old male who presented with COPD exacerbation with thick mucous and wheezing, complicating his tenuous resp status with chronic resp failure from prior ICH, requiring trans-trach O2 and nocturnal vent at baseline. He actually was only modestly ill with this, afebrile and without sepsis. Started on IV steroids and frequent nebs along with supportive care. His initial CXR was read as LLL pneumonia. WBC and procalcitonin was negative, however. Subsequent resp pathogens panel was pos for RSV. His abx were stopped. He improved with respect to his wheezing and was stronger on am of discharge as well. Felt to be safe going home with the excellent care from his wife." MEDICAL HISTORY: ?COPD although no history of smoking, but hx of occupational exposure. Cerebellar dural AVM s/p hemorrhage 2008 necessitating tracheostomy due to chronic hypoventilation Chronic bacterial colonization due to hypoventilation with 2 hospitalizations in the past year Arteriosclerosis. ? possible pleural plaque related to asbestos exposure. Tics Social history: Worked with a lot of tanks in Fort Knox and had significant exposure to fumes and probably asbestos and herbicides, Was an artillery tank mechanical. Army 1962-1964. Reserves for four years after that. Baggage handler for United after that. Smoking: Never smoker Alcohol: Rarely Drugs: None Family history: None TEST RESULTS: CT Hi-res 3/12/17 Impression: Consolidations at both lung bases, infection not excluded Coronary artery calcification. Cardiomegaly Tracheostomy tube VITAL SIGNS: Temp:97.2 F [36.2 C] (12/30/2016 13:10) Pulse:63 (12/30/2016 13:10) Resp:20 (12/30/2016 13:10) BP:102/62 (12/30/2016 13:10) Height:71 in [180.3 cm] (12/30/2016 13:10) Weight:231.7 lb [105.3 kg] (02/22/2017 13:11) Pain:7 (12/30/2016 13:10) Pulse Ox rest: " " walk: PHYSICAL EXAM: Gen: Male

Here is the most recent CT Exam GOOD SAMARITAN MEDICAL CENTER Adm: 6/6/2017, D/C: 6/6/2017 CT Chest Abdomen And Pelvis Wo Contrast] Resulted: 06/06/17 1617, Result status: Final result Ordering provider: Resulted by: MD Performed: 06/06/17 1522 - 06/06/17 1539 Resulting lab: SVB STRESS SERVICES Narrative: CT OF THE CHEST, ABDOMEN AND PELVIS WITHOUT INTRAVENOUS CONTRAST EXAM DATE AND TIME: 6/6/2017 3:22 PM INDICATION: Lung mass. Vascular disorder of the kidneys. TECHNIQUE: Routine CT of the chest, abdomen and pelvis without IV contrast. Dose reduction techniques were employed. COMPARISON: None available. FINDINGS: CHEST: Lungs: Evaluation lung bases is hindered by extensive respiratory motion artifact. There is patchy left greater than right bilateral lower lobe consolidations, consistent with pneumonia and/or atelectasis. The upper lobes appear clear. Mediastinum/Hila: There is mild cardiomegaly. Aortic valvular calcifications are noted. Calcified plaque is seen in the aortic arch. No mediastinal or hilar adenopathy. Tracheostomy tube appears in satisfactory position. Pleura: Tiny left pleural effusion. Chest Wall: Right-sided VP shunt catheter is seen in the subcutaneous right anterior chest wall, terminating in the right upper quadrant of the abdomen. ABDOMEN: Liver: Normal size and homogeneous, without focal suspicious parenchymal lesion. Gallbladder/Bile Ducts: Few tiny calcified gallstones are seen layering in the gallbladder, which otherwise appears unremarkable. There is no biliary dilation. Pancreas: The pancreas appears normal. Spleen: The spleen appears normal. Adrenals: The adrenal glands appear normal. Kidneys: 3.3 cm simple left upper pole renal cyst. No hydronephrosis or nephrolithiasis. Bowel: Numerous colonic diverticuli are noted, without CT evidence of acute diverticulitis. Mesentery/Omentum/Peritoneum: The mesentery, omentum and peritoneum appear normal. Lymph Nodes: Lymph nodes appear normal. No adenopathy. Vessels: Calcified plaque in the abdominal aorta, without evidence of aneurysm. Abdominal Wall: The abdominal wall appears normal. PELVIS: Unremarkable urinary bladder. Unremarkable prostate gland. No free air. No free fluid. Printed on 6/8/2017 9:37 AM Page 1 GOOD SAMARITAN MEDICAL CENTER 200 Exempla Cir Lafayette CO 80026 FREDRICK,GERALD W MRN: S0406306 DOB: 2/28/1940, Sex: M Adm: 6/6/2017, D/C: 6/6/2017 CT Chest Abdomen And Pelvis Wo Contrast [213904399] (continued) Resulted: 06/06/17 1617, Result status: Final result BONES: Multilevel degenerative changes in the lumbar spine are noted. No destructive bony lytic or sclerotic osseous lesion. IMPRESSION: 1. Patchy bilateral lower lobe left greater than right consolidations, possibly representing atelectasis and/or pneumonia. Evaluation of these regions are hindered by extensive respiratory motion artifacts. Underlying mass, while considered less likely cannot entirely be excluded. Follow-up chest CT suggested after resolution of acute symptoms. 2. Right-sided VP shunt apparently in satisfactory position, tip terminating right upper quadrant. 3. Cholelithiasis, without CT evidence of acute cholecystitis. 4. Diverticulosis, without CT evidence of acute diverticulitis. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED: MD 6/6/2017 4:17 PM Contributed By: Printed What do you see in this report? as compared to the initial finding in February? 02/19/2017 6:16 PM Ordered By: , MD Result Status: Final result CT ABDOMEN AND PELVIS WO CONTRAST - Details About This Test The My Chart portal may not provide a complete representation of the laboratory test results in your medical record. If you have questions, please contact your physician. If the report is not complete, you may contact Health Information Management for a complete report. · Details Narrative HISTORY: 76M. Diarrhea. Noncontrast CT abdomen and pelvis with coronal and sagittal reformats. FINDINGS: Mild basilar atelectasis. Mild cardiomegaly. Right abdominal ventriculoperitoneal shunt partially seen extending along the liver. Dependent cholelithiasis without pericholecystic inflammation. Unremarkable spleen, adrenals, pancreas. Retroperitoneal lipomatosis with mildly atretic kidneys. Left renal 3.3 cm hypodense lesion with indeterminate density. Diffuse fluid-filled stomach, small bowel, and large bowel without evidence of obstruction compatible with infectious gastroenteritis/enterocolitis and diarrhea. Normal appendix, axial image 64. Distal colonic diverticulosis without diverticulitis. Central mesenteric misty appearance with subcentimeter lymph nodes. Unremarkable bladder. No free fluid or free air. Small fat-containing inguinal hernia is without inflammation. Bowel seen immediately deep to the umbilicus. No acute osseous finding. IMPRESSION: 1. Diffuse fluid-filled stomach and bowel compatible with infectious gastroenteritis or enterocolitis. 2. Indeterminate left renal 3.3 cm lesion, most, a hyperdense cyst. Recommend all sound further evaluate if not stable on prior exams. 3. Cholelithiasis. 4. Central mesenteric misty appearance with subcentimeter lymph nodes most commonly associated with mesenteric panniculitis or sclerosing mesenteritis. Consider 6 month follow-up CT abdomen. Component Results There is no component information for this result. General Information Collected: 02/19/2017 7:02 PM Resulted: 02/19/2017 7:02 PM Ordered By: MD Result Status: Final result Help Please!!!! Blood Testing KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM KAPPA LIGHT CHAIN, FREE, SERUM Reference Range: 3.3-19.4 (mg/L) Actual 41.3 H LAMBDA LIGHT CHAIN, FREE, SERUM Reference Range: 5.7-26.3 (mg/L) Actual 24.2 KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM Reference Range: 0.26-1.65 Actual 1.71 H DOB: 02/28/1940 Sex: M Phone: Patient ID: Age: 77 Fasting: Specimen: KS400824A Requisition: 7737005 Report Status: FINAL / SEE REPORT Collected: 05/31/2017 17:19 Received: 06/02/2017 06:23 Reported: 06/09/2017 05:21 Client #: 70300946 Quest, Quest Diagnostics, the associated logo, Nichols Institute, Interactive Insights and all associated Quest Diagnostics marks are the registered trademarks of Quest Diagnostics. All third party marks - '®' and '™' - are the property of their respective owners. Privacy policy can be found at: http://questdiagnostics.com/home/privacy-policy/online-privacy.html. © 2017 Quest Diagnostics Incorporated. All rights reserved. These results have been sent to the person that ordered the tests. Your receipt of these results should not be viewed as medical advice and is not meant to replace discussion with your doctor or other healthcare professional. Performing Sites AMD Quest Diagnostics/Nichols Chantilly-Chantilly VA, 14225 Newbrook Drive, Chantilly, VA 20151-2228 Laboratory Director: Patrick W Mason M.D.,PhD EZ Quest Diagnostics/Nichols SJC-San Juan Capistrano,, 33608 Ortega Hwy, San Juan Capistrano, CA 92675-2042 Laboratory Director: Jon Nakamoto MD,PhD THYROGLOBULIN THYROGLOBULIN Reference Range: <0.1 (ng/mL) Reference range applies to differentiated thyroid cancer patients following treatment. The presence of measurable thyroglobulin indicates the presence of thyroglobulin-producing thyroid tissue. Clinical correlation is advised. This test was performed using the Beckman Coulter Chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. Thyroglobulin levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. THYROID CANCER (THYROGLOBULIN) MONITOR THYROGLOBULIN ANTIBODY Reference Range: <=1 (IU/mL) This Thyroglobulin antibody test was performed using the Beckman Coulter Immunoenzymatic method. Values obtained from different assay methods cannot be used interchangeably. Thyroglobulin antibody levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. If the sample contains anti-thyroglobulin antibodies of greater than 1 IU/mL, the presence of these autoantibodies may cause falsely low thyroglobulin values. SEROTONIN, SERUM SEROTONIN, SERUM Reference Range: 56-244 (ng/mL) This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. 10.4 H

By all means become a premium member. You can not only get access to the general VA records there, but RX ordering etc. If you want detailed report then you need to go to the VA health system records dept and request a copy. Can do either by completing the mail in Hippa Request or in person. Quicker in person.

While we have been waiting on the NOD since June 2015, I have continued with my research and medical documentation. A couple of months ago they sent me for a round of tests,exams, CT's. PFT's etc. Very thorough, very managed. And done by the Chief MD of each Dept. In the process we found more evidence, and then last visit with primary care, she tells me that she is referring us to the C and P DBQ Clinic which I has never heard of. Was not sure about going but decided my Nexus doc's curriculum vitae is very extensive and at best I think the VA docs may be MDs but with far less experience. So we went on Wednesday and did 3 DBQ's, Lungs, Heart, and Hypertension. I went prepared with documents and showed him the evidence of spraying of herbicides/pesticides I found, the statement from the base Entomologist, evidence that showed HIDAL spray systems from the nearby MEDAC Evac Hosp, and statements from other soldiers. He gave me a form to give to the RO about this that stated the DBQs were done in Vista, he told me he had access to all of the studies and tests, and that the DBQs would be up and in my husbands medical record in a couple of days. He suggested filing for CAD as well which I will do once I see what the DBQ says and if needed I will get an IMO as well. I will send all with the claim, since the CT showed an enlarged heart, both aorta and coronary artery with plaques and Afib as well. Some mitral valve regurgitation and a Peri Cardial effusion. Like I said I think I have given them ample evidence of the events with spraying not to mention the other pollutants and toxics he was around including Diesel exhausts. I hand carried it in to RO yesterday, and pending the info being reviewed we will see if this triggers anything. Hopefully they will move on it. I will see what the DBQ says in a couple of days I guess,